{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:49:39Z","timestamp":1792093779900,"version":"4.4.0"},"reference-count":39,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":12,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009797","name":"Barrow Neurological Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009797","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","journalofhospitalinfection.com","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Journal of Hospital Infection"],"published-print":{"date-parts":[[2026,10]]},"DOI":"10.1016\/j.jhin.2026.10.004","type":"journal-article","created":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:24:28Z","timestamp":1792020268000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":0,"title":["COMPREHENSIVE ORAL CARE IS ASSOCIATED WITH A SIGNIFICANT DECREASE IN VENTILATOR-ASSOCIATED PNEUMONIA: A SINGLE CENTER PROSPECTIVE COHORT STUDY"],"prefix":"10.1016","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-6893-4659","authenticated-orcid":false,"given":"Michelle L.","family":"Belusic","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5380-837X","authenticated-orcid":false,"given":"Kelley A.","family":"Brunst","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina M.","family":"Kupanoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar Y.","family":"Gonzalez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"issue":"5","key":"10.1016\/j.jhin.2026.10.004_bib1","doi-asserted-by":"crossref","first-page":"888","DOI":"10.1007\/s00134-020-05980-0","article-title":"Ventilator-associated pneumonia in adults: a narrative review","volume":"46","author":"Papazian","year":"2020","journal-title":"Intensive Care Med"},{"issue":"9","key":"10.1016\/j.jhin.2026.10.004_bib2","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1016\/j.cmi.2025.05.026","article-title":"Incidence, microbiology, and mortality of ventilation-associated pneumonia in a large Italian cohort of critically ill patients: results from the PROSAFE project","volume":"31","author":"Colaneri","year":"2025","journal-title":"Clin Microbiol Infect"},{"issue":"12","key":"10.1016\/j.jhin.2026.10.004_bib3","doi-asserted-by":"crossref","first-page":"2736","DOI":"10.1097\/CCM.0b013e3182281f33","article-title":"Estimating the attributable mortality of ventilator-associated pneumonia from randomized prevention studies","volume":"39","author":"Melsen","year":"2011","journal-title":"Crit Care Med"},{"issue":"8","key":"10.1016\/j.jhin.2026.10.004_bib4","doi-asserted-by":"crossref","first-page":"665","DOI":"10.1016\/S1473-3099(13)70081-1","article-title":"Attributable mortality of ventilator-associated pneumonia: a meta-analysis of individual patient data from randomised prevention studies","volume":"13","author":"Melsen","year":"2013","journal-title":"Lancet Infect Dis"},{"issue":"5","key":"10.1016\/j.jhin.2026.10.004_bib5","first-page":"464","article-title":"Attributable mortality of ventilator-associated pneumonia","volume":"17","author":"Timsit","year":"2011","journal-title":"Curr Opin Crit Care"},{"key":"10.1016\/j.jhin.2026.10.004_bib6","unstructured":"Estimating the Additional Hospital Inpatient Cost and Mortality Associated with Selected Hospital-Acquired Conditions. In: Quality HaHSAfHRa, ed. Rockville, MD; 2017."},{"key":"10.1016\/j.jhin.2026.10.004_bib7","unstructured":"Hospital-Acquired Condition Reduction Program, https:\/\/www.cms.gov\/medicare\/payment\/prospective-payment-systems\/acute-inpatient-pps\/hospital-acquired-condition-reduction-program-hacrp; 2026 [accessed April 16 2026]."},{"issue":"10","key":"10.1016\/j.jhin.2026.10.004_bib8","first-page":"CD008367","article-title":"Oral hygiene care for critically ill patients to prevent ventilator-associated pneumonia","volume":"10","author":"Hua","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"1","key":"10.1016\/j.jhin.2026.10.004_bib9","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1186\/s13054-025-05576-4","article-title":"Oral care for intubated patients in the intensive care unit: examination of bacterial count and microbiota","volume":"29","author":"Kanamori","year":"2025","journal-title":"Crit Care"},{"issue":"Suppl 14","key":"10.1016\/j.jhin.2026.10.004_bib10","first-page":"S8","article-title":"Periodontal systemic associations: review of the evidence","volume":"40","author":"Linden","year":"2013","journal-title":"J Clin Periodontol"},{"issue":"3","key":"10.1016\/j.jhin.2026.10.004_bib11","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4037\/ccn2022672","article-title":"Oral Microbes in Hospital-Acquired Pneumonia: Practice and Research Implications","volume":"42","author":"Rathbun","year":"2022","journal-title":"Crit Care Nurse"},{"issue":"4","key":"10.1016\/j.jhin.2026.10.004_bib12","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1097\/CNQ.0000000000000522","article-title":"Care Bundle Approach for Oral Health Maintenance and Reduction of Ventilator-Associated Pneumonia","volume":"47","author":"Sabrah","year":"2024","journal-title":"Crit Care Nurs Q"},{"issue":"7","key":"10.1016\/j.jhin.2026.10.004_bib13","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1111\/odi.12535","article-title":"Oral health and ventilator-associated pneumonia among critically ill patients: a prospective study","volume":"22","author":"Saensom","year":"2016","journal-title":"Oral Dis"},{"issue":"1","key":"10.1016\/j.jhin.2026.10.004_bib14","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1186\/s13054-021-03765-5","article-title":"Oral health care for the critically ill: a narrative review","volume":"25","author":"Winning","year":"2021","journal-title":"Crit Care"},{"issue":"1","key":"10.1016\/j.jhin.2026.10.004_bib15","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/idh.12401","article-title":"How effective is a powered toothbrush as compared to a manual toothbrush? A systematic review and meta-analysis of single brushing exercises","volume":"18","author":"Elkerbout","year":"2020","journal-title":"Int J Dent Hyg"},{"issue":"1","key":"10.1016\/j.jhin.2026.10.004_bib16","first-page":"3","article-title":"The effects of oscillating-rotating electric toothbrushes on plaque and gingival health: A meta-analysis","volume":"33","author":"Grender","year":"2020","journal-title":"Am J Dent"},{"issue":"6","key":"10.1016\/j.jhin.2026.10.004_bib17","first-page":"351","article-title":"Randomized controlled trial comparing a powered toothbrush with distinct multi-directional cleaning action to a manual flat trim toothbrush","volume":"28","author":"Gallob","year":"2015","journal-title":"Am J Dent"},{"issue":"1","key":"10.1016\/j.jhin.2026.10.004_bib18","first-page":"27","article-title":"An 8-Week Clinical Comparison of an Oscillating-Rotating Electric Rechargeable Toothbrush and a Sonic Toothbrush in the Reduction of Gingivitis and Plaque","volume":"29","author":"Ccahuana-Vasquez","year":"2018","journal-title":"J Clin Dent"},{"issue":"2","key":"10.1016\/j.jhin.2026.10.004_bib19","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1001\/jamainternmed.2023.6638","article-title":"Association Between Daily Toothbrushing and Hospital-Acquired Pneumonia: A Systematic Review and Meta-Analysis","volume":"184","author":"Ehrenzeller","year":"2024","journal-title":"JAMA Intern Med"},{"issue":"2","key":"10.1016\/j.jhin.2026.10.004_bib20","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1378\/chest.09-0706","article-title":"A randomized trial of dental brushing for preventing ventilator-associated pneumonia","volume":"136","author":"Pobo","year":"2009","journal-title":"Chest"},{"issue":"4","key":"10.1016\/j.jhin.2026.10.004_bib21","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1097\/JNR.0b013e318236d05f","article-title":"Brushing teeth with purified water to reduce ventilator-associated pneumonia","volume":"19","author":"Yao","year":"2011","journal-title":"J Nurs Res"},{"issue":"3","key":"10.1016\/j.jhin.2026.10.004_bib22","first-page":"325","article-title":"Development, testing, and application of the oral assessment guide","volume":"15","author":"Eilers","year":"1988","journal-title":"Oncol Nurs Forum"},{"issue":"3","key":"10.1016\/j.jhin.2026.10.004_bib23","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1097\/JNN.0b013e3182510688","article-title":"Effects of a standard versus comprehensive oral care protocol among intubated neuroscience ICU patients: results of a randomized controlled trial","volume":"44","author":"Prendergast","year":"2012","journal-title":"J Neurosci Nurs"},{"key":"10.1016\/j.jhin.2026.10.004_bib24","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1016\/j.jhin.2026.06.008","article-title":"Evaluation of the effectiveness of oral hygiene protocols adopted for the prevention of ventilator-associated pneumonia and mortality in the adult intensive care unit: a systematic review","volume":"174","author":"Gomes","year":"2026","journal-title":"J Hosp Infect"},{"issue":"9","key":"10.1016\/j.jhin.2026.10.004_bib25","doi-asserted-by":"crossref","first-page":"1055","DOI":"10.1016\/j.ajic.2021.11.026","article-title":"The impact of dental care intervention on ventilator-associate events: A Quasi-experimental study","volume":"50","author":"Sabino","year":"2022","journal-title":"Am J Infect Control"},{"issue":"3","key":"10.1016\/j.jhin.2026.10.004_bib26","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1111\/j.1600-051X.2010.01688.x","article-title":"Randomized controlled trial of toothbrushing to reduce ventilator-associated pneumonia pathogens and dental plaque in a critical care unit","volume":"38","author":"Needleman","year":"2011","journal-title":"J Clin Periodontol"},{"issue":"6","key":"10.1016\/j.jhin.2026.10.004_bib27","doi-asserted-by":"crossref","first-page":"433","DOI":"10.7326\/0003-4819-129-6-199809150-00002","article-title":"Incidence of and risk factors for ventilator-associated pneumonia in critically ill patients","volume":"129","author":"Cook","year":"1998","journal-title":"Ann Intern Med"},{"key":"10.1016\/j.jhin.2026.10.004_bib28","unstructured":"Pneumonia (Ventilator-associated [VAP] and non-ventilatorassociated Pneumonia [PNEU]) Event. In: Network NHS, ed.: Centers for Disease Control and Prevention; 2026:1-20."},{"issue":"6","key":"10.1016\/j.jhin.2026.10.004_bib29","first-page":"CD002281","article-title":"Powered versus manual toothbrushing for oral health","volume":"2014","author":"Yaacob","year":"2014","journal-title":"Cochrane Database Syst Rev"},{"issue":"4","key":"10.1016\/j.jhin.2026.10.004_bib30","doi-asserted-by":"crossref","first-page":"799","DOI":"10.1016\/j.cden.2015.06.002","article-title":"Can Chemical Mouthwash Agents Achieve Plaque\/Gingivitis Control?","volume":"59","author":"Van der Weijden","year":"2015","journal-title":"Dent Clin North Am"},{"issue":"1","key":"10.1016\/j.jhin.2026.10.004_bib31","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1111\/idh.12563","article-title":"The efficacy of powered toothbrushes: A systematic review and network meta-analysis","volume":"20","author":"Thomassen","year":"2022","journal-title":"Int J Dent Hyg"},{"issue":"6","key":"10.1016\/j.jhin.2026.10.004_bib32","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1017\/ice.2022.88","article-title":"Strategies to prevent ventilator-associated pneumonia, ventilator-associated events, and nonventilator hospital-acquired pneumonia in acute-care hospitals: 2022 Update","volume":"43","author":"Klompas","year":"2022","journal-title":"Infect Control Hosp Epidemiol"},{"issue":"4","key":"10.1016\/j.jhin.2026.10.004_bib33","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1016\/j.idh.2019.06.002","article-title":"Strategies to reduce non-ventilator-associated hospital-acquired pneumonia: A systematic review","volume":"24","author":"Mitchell","year":"2019","journal-title":"Infect Dis Health"},{"issue":"11","key":"10.1016\/j.jhin.2026.10.004_bib34","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1007\/s00134-021-06475-2","article-title":"Effect of oral chlorhexidine de-adoption and implementation of an oral care bundle on mortality for mechanically ventilated patients in the intensive care unit (CHORAL): a multi-center stepped wedge cluster-randomized controlled trial","volume":"47","author":"Dale","year":"2021","journal-title":"Intensive Care Med"},{"issue":"7","key":"10.1016\/j.jhin.2026.10.004_bib35","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1007\/s00134-018-5171-3","article-title":"Effects of chlorhexidine gluconate oral care on hospital mortality: a hospital-wide, observational cohort study","volume":"44","author":"Deschepper","year":"2018","journal-title":"Intensive Care Med"},{"key":"10.1016\/j.jhin.2026.10.004_bib36","article-title":"Should oral chlorhexidine remain in ventilator-associated pneumonia prevention bundles?","author":"Vieira","year":"2020","journal-title":"Med Intensiva (Engl Ed)"},{"issue":"1","key":"10.1016\/j.jhin.2026.10.004_bib37","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1186\/s44158-024-00166-2","article-title":"Chlorhexidine is not effective at any concentration in preventing ventilator-associated pneumonia: a systematic review and network meta-analysis","volume":"4","author":"De Cassai","year":"2024","journal-title":"J Anesth Analg Crit Care"},{"key":"10.1016\/j.jhin.2026.10.004_bib38","doi-asserted-by":"crossref","first-page":"5299","DOI":"10.2147\/JMDH.S476253","article-title":"Removal of Chlorhexidine for Ventilator-Associated Pneumonia Prevention with a Dentist Composing the Intensive Care Unit Team","volume":"17","author":"Pains","year":"2024","journal-title":"J Multidiscip Healthc"},{"key":"10.1016\/j.jhin.2026.10.004_bib39","unstructured":"Oral Health in Healthcare Settings to Prevent Pneumonia Toolkit, https:\/\/www.cdc.gov\/healthcare-associated-infections\/hcp\/prevention-healthcare\/oral-health-pneumonia-toolkit.html#:\u223c:text=Some%20examples%20of%20oral%20care%20procedures%20include:,Affairs%2C%20Brush%20Your%20Teeth%20to%20Prevent%20Pneumonia; 2024 [accessed April 27 2026]."}],"container-title":["Journal of Hospital Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0195670126003981?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S0195670126003981?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T19:27:57Z","timestamp":1792092477000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S0195670126003981"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10]]},"references-count":39,"alternative-id":["S0195670126003981"],"URL":"https:\/\/doi.org\/10.1016\/j.jhin.2026.10.004","relation":{},"ISSN":["0195-6701"],"issn-type":[{"value":"0195-6701","type":"print"}],"subject":[],"published":{"date-parts":[[2026,10]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"COMPREHENSIVE ORAL CARE IS ASSOCIATED WITH A SIGNIFICANT DECREASE IN VENTILATOR-ASSOCIATED PNEUMONIA: A SINGLE CENTER PROSPECTIVE COHORT STUDY","name":"articletitle","label":"Article Title"},{"value":"Journal of Hospital Infection","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.jhin.2026.10.004","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2026 The Author(s). Published by Elsevier Ltd on behalf of The Healthcare Infection Society.","name":"copyright","label":"Copyright"}]}}